5
Campaign Objectives Inform people of the extent of diabetic foot problems worldwide. Persuade people that action is both possible and affordable. Warn people of the consequences of not taking action.

6
FOOT FACTS (1) Every 30 seconds a leg is lost to diabetes somewhere in the world. Up to 70% of all leg amputations happen to people with diabetes. DF problems are the commonest cause of hospital admission. (by us?)

7
FOOT FACTS (2) Most amputations begin with a foot ulcer. One in every six people with diabetes will have a foot ulcer during their lifetime. Good News Up to 85% of amputations can be avoided.

13
Five cornerstones of the management of the diabetic foot Regular inspection and examination of the foot. Identification of the foot at risk. Education of patient, family and healthcare providers. Appropriate footwear. Treatment of non ulcerative pathology

14
Five cornerstones of the management of the diabetic foot Regular inspection and examination of the foot. Identification of the foot at risk. Education of patient, family and healthcare providers. Appropriate footwear. Treatment of non ulcerative pathology

15
Regular inspection and examination of the foot All diabetic patients should be examined at first presentation then at least once a year Patients with risk factors should be examined every 1-6 months Absent symptoms does not mean that the feet are healthy Examine the patient on lying down and standing up Shoe and socks should be inspected

29
Callus Presence of callus is a significant marker for the development of foot ulceration The hyperkeratosis is a result of hypertrophy under the influence of intermittent compression. the callus is either a reaction to abnormal pressure or an abnormality of the area to handle normal pressure.

53
Five cornerstones of the management of the diabetic foot Regular inspection and examination of the foot. Identification of the foot at risk. Education of patient, family and healthcare providers. Appropriate footwear. Treatment of non ulcerative pathology

56
Five cornerstones of the management of the diabetic foot Regular inspection and examination of the foot. Identification of the foot at risk. Education of patient, family and healthcare providers. Appropriate footwear. Treatment of non ulcerative pathology

57
Five cornerstones of the management of the diabetic foot Regular inspection and examination of the foot. Identification of the foot at risk. Education of patient, family and healthcare providers. Appropriate footwear. Treatment of non ulcerative pathology

58
Five cornerstones of the management of the diabetic foot Regular inspection and examination of the foot. Identification of the foot at risk. Education of patient, family and healthcare providers. Appropriate footwear. Treatment of non ulcerative pathology

61
Ulcer assessment 1.Establish the ulcer's etiology 2.Measure its size 3.Establish its depth and involvement of deep structures 4.Examine it for purulent exudates, necrosis, sinus tracts, and odor 5.Assess the surrounding tissue for signs of edema, cellulitis, abscess, and fluctuation 6.Exclude systemic infection 7.Perform a vascular evaluation. 8.The ability to gently probe through the ulcer to bone has been shown to be highly predictive of osteomyelitis. ( should be recorded at base line and every subsequent visits ± digital photo)

66
Offlaoding What is meant by offloading Different offloading modalities

67
Key Message Of all late complications of diabetes, foot problems are the most easily detectable and easily preventable. Relatively simple interventions can reduce amputations by %. (Bakker et al 1994). Strategies aimed at preventing foot ulcers are cost effective and cost saving. Only champions willing to act are needed.